Plaid’s vision for a 21st Century NHS

There is better integration of health and social care in agriculture than in the Welsh NHS is the view of Ceredigion AM Elin Jones. She was Minister for Rural Affairs in the coalition government in Cardiff Bay between 2007 and 2011 and for the last four years she has been Plaid’s Shadow Health Minister. Comparing her two roles in an important speech on the future of the NHS last week she said, “Farmers do the social care bit, and vets do the health care – and they do it in an integrated, effective way – even in times of crisis.”

Elin has put her finger on an urgent question that will touch the life of everybody reading this column. What happens to us when we reach older age? In the middle of the last century the NHS was designed for people of working age. Today’s problems of coping with large numbers of confused, ill and vulnerable older people didn’t exist then, simply because most people didn’t live into their eighties. Elin is right when she says we must fundamentally redesign the NHS to take account of this change.

She has come up with a costed plan that will abolish all social care charges for older people in three stages over two Assembly terms. A Plaid-led government would introduce free personal care for older people within two years, at a cost of £32 million. Within five years charges for people with a dementia diagnosis – including those for nursing and residential care - would be abolished, at a cost of £134 million. And all social care charges would be abolished within the second term of a Plaid government, at a remaining cost of £60 million. These commitments will be in Plaid’s manifesto for next year’s Assembly election.

Plaid would create a Community NHS, led by local authorities to be responsible for GP surgeries, community nursing teams and health professionals, community hospitals, mental health services, and adult social care. At the same time a single National Health Board would be created to run Wales’s 20 acute and specialist hospitals. The present Health Boards, including Hywel Dda, would be abolished. We do not need eight of them, together with their chief executives and management teams, to run an effective secondary care health service for a nation of just three million people.

What benefits would be gained from these changes? First, budgets for primary, community and social care would be protected. At present they are decided by the Health Boards and have to compete with the demands of the acute and specialist hospitals. The Health Boards, including our own, have consistently cut GP funding, the most effective front line against people requiring hospital treatment.

Second, out-of-hospital care, especially for the elderly, would be planned seamlessly and democratically. Third, the National Health Board would put in place a strategic and fair service for the Welsh population as a whole, ensuring that everyone can be reached by the emergency services within a reasonable time. As Elin says, “Our acute hospitals would continue to serve their localities and we would guarantee that every part of Wales would remain with an hour’s reach of life saving services.” For Pembrokeshire this would guarantee the continued provision of emergency services, including maternity care, at Withybush.